CLIMATE CHANGE HEALTH CHECK 2020 - Doctors for the ... · World Health Organisation is...

CLIMATE CHANGEHEALTH CHECK 2020Prepared by Dr Graeme Horton, Professor Tony McMichaelDoctors for the Environment, Australia

April 2008

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Doctors for the Environment, Australia (DEA) is a voluntary, doctor’sorganization, formed in 2001, with members in all States and Territories. Theaim of the organisation is to inform and educate the public, the medicalprofession and policy makers about the relationships between health and theenvironment. Our priority issue at the present time is the health effects ofclimate change. DEA is a member of the International Society of Doctors forthe Environment.

www.dea.org.au

The Climate Institute is a non-partisan, independent research organisation that works with community,business and government to drive innovative and effective climate change solutions. Our vision is for an Australia leading the world in clean energy use and innovation, with clean and low energysolutions a part of everyday life throughout the community, government and businesswww.climateinstitute.org.au

CLIMATE CHANGE HEALTH CHECK 2020Dr Graeme Horton

Professor Tony McMichael

Doctors for the Environment, Australia

April 2008

A report prepared for the Climate Institute of Australia in relation to World Health Day on April 7, 2008 for which the World HealthOrganisation’s theme is ‘Protecting Health from Climate Change’.

Endorsed by the Royal Australian College of General Practitioners.

Executive Summary The World Health Organisation (WHO) has chosen “protecting health fromclimate change” as the theme for this year’s World Health Day on April 7. WHOselected this theme in recognition that climate change is posing ever growingthreats to global public health security and that “wherever you live, climatechange threatens your health”.

WHO notes that global warming induced by climate change dramatically disruptssome of life’s basic essential requirements for health: water, air and food.According to WHO, health damage from climate change is already happening.This report for the Climate Institute summarises recent research on health risksand effective responses with a focus on minimizing human health impacts ofclimate change in Australia in 2020 and beyond. In particular the reportemphasises expected changes in medical practice and how patients will come totheir doctors in future years with illness due to climate change:

1In 2020, it is likely that Australian doctors and other healthprofessionals will be seeing patients with a diverse range ofclimate change-related illnesses. These include heat stress, other

heat-related illness events (affecting the heart, blood vessels and lungs),trauma from extreme weather events, and more allergic diseases. Inthose areas affected by long-term drought and other natural disasters, itis likely that patients will experience distress and more mental illnesssuch as depression and post traumatic stress disorders. It is anticipatedthat there will be a changes in airborne pollutants leading to increasedrespiratory problems. The incidence of some infectious diseases such asgastroenteritis (‘food poisoning’) is predicted to rise and there will bechanges in the distribution of mosquito-transmitted diseases such asDengue fever and Ross River virus.

2 The more vulnerable members of our community will be mostaffected by climate related illnesses. These include the elderlywho cope less well with changes in temperature, and young

children whose developing lungs are susceptible to ambient air pollution.Rural, regional and some remote indigenous communities will face moreclimatic extremes and changes to food supplies and freshwater. Somecoastal communities may face relocation due to inundation with stormsand flooding. Food and water insecurity in other parts of the world aswell as sea level rise may contribute to the need for us to care forincreased numbers of environmental refugees.


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3Climate change is of great relevance to the health care whichwill be provided by health professionals in coming years.Australians need to know how our changing climate will affect

the health of our community and there is an important role for healthprofessionals to raise awareness in this area.

4 Health care for 2020 and beyond needs to be increasinglyresponsive to the health needs of our community which will ariseas a result of climate change. Planning for climate change

should be part of every future deliberation in health services and thisshould include preparation for potentially large numbers of environmentalrefugees in our region as the century progresses. Effective healthstrategies will require collaboration between health professionals andother sectors of the community.

5 There are many opportunities for doctors and the rest of thehealth sector to implement solutions which promote thecommunity’s health whilst protecting the environment and

reducing greenhouse gas emissions. Health professionals can andshould play an increased role in advocating community responses toprotect health from climate change, including by engaging in policydevelopment with other professional groups and sectors of government.


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Introduction Doctors along with the rest of the community now realise that the effects ofclimate change are upon us (1). There is increasing focus on the resulting humanhealth impacts; indeed, the topic selected for World Health Day on April 7 by theWorld Health Organisation is “protecting health from climate change”. WHOestimates that climate change already accounts for more than 60,000 deaths,globally, from climate-related natural disasters every year (2), along with at leastanother 100,000 deaths from malaria, malnutrition and child diarrhoea (3).

Australian doctors and the communities which we serve have the opportunity towork together to limit the severity of these effects. We can do this both byreducing the production of greenhouse gases and by ensuring that those whosuffer with adverse health impacts of climate change receive the care they need.Temperatures are predicted to continue to rise during this century. In order todetermine how doctors and other health professionals might best engage withwhat lies ahead, it is useful to consider how patients will come to their doctors infuture years with illness due to climate change.


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Health Effects on AustralianCommunities in 2020 and BeyondThe effects of climate change will vary around the world depending on factorswhich include the response of the local climate and the vulnerability and adaptivecapacity of communities. Figure 1 indicates the impacts which Australia may faceas a result of climate change, alongside those expected to affect other countriesin coming decades. It can be seen that heat stress and vector borne diseases arepredicted to be adversely affected by climate change, as are other factors whichinfluence health such as water resources and integrity of ecosystems (foodyields, fish stocks, water cleansing, environmental stabilisation, etc.).

FIGURE 1 – Dark effects of climate change (4)

Climate change will lead to a wide range of adverse health impacts in Australiawhich are featured in Box 1 and discussed below.


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Water resourcesMarine ecosystemsForest ecosystems

Grassland ecosystemsLakes, rivers and wetlands

WildlifeCoastal ecosystems

Commercial agriculture

LivestockForestry

Coastal settlementsUrban areas

Heat stressVector-borne diseases

Increases energy demandTransport

Construction industryTourism

Subsitence agriculture

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Heatwaves, Heat Stress and Bushfires

Australians will experience more heatwaves in coming years. The deadly natureof these events was shown during the European heatwaves of 2003 whichclaimed over 35,000 lives. Those who were most vulnerable were those withrestricted mobility and the elderly, particularly those who lived alone (5). Theeffects of increased temperature in heatwaves is heightened by reduced fluidintake, alcohol or drug use, too much physical activity in the heat, especially ifoutdoors, as well as low income, cardiac disease and mental illness (6)Researchers have begun to predict by how much the mortality rate fromheatwaves will increase by 2020. In the case of Lisbon, Portugal the death rate isexpected to rise from between 5.4 and 6.0 (per 100,000) for 1980–1998 tobetween 5.8 and 15.1 for the 2020s. (7) Residents of urban areas areconsidered to be more at risk than those in rural areas (8). In cities the “heatisland” effect means that in heavily built up areas with limited vegetation thetemperatures tend to be higher. This is because buildings, asphalt and concreteabsorb heat during the day and this is radiated back to the surroundings duringthe night.

Research has commenced in Australia to determine how vulnerable we are toheat-related illness and death. A study which has examined past heatwaves haspredicted that the risk of death from heatwaves is likely to be higher in oursouthern cities than in our warmer northern ones (7). This is due to people whoare not used to warm temperatures and who have not modified theirsurroundings accordingly being more vulnerable to large fluctuations oftemperature as occurs with heatwaves.

Heatwaves, together with more hot dry conditions, are also expected to increaseour risk of bushfires in coming years (10). Figure 2 depicts the increased risk forvery high and extreme high fire danger days for areas of South Eastern Australiaas reported by the Bushfire Collaborative Research Centre and the CSIRO.Estimated risk is shown for the years 2020 and 2050 for both “low” and “high”global warming scenarios. In Australia we are all too familiar with the devastationwrought by bushfires in both urban and rural areas and the human cost includesfatalities, injuries and burns. Poor air quality due to increased particle density is amajor cause of respiratory disease due to bushfires.


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FIGURE 2: Percent changes in the number of days with very high and extremefire-weather – 2020 and 2050, relative to 1990 (10)

Storms and Other Extreme Weather Events.

It is predicted that the frequency of extreme weather events such as storms andheavy rain will increase and this will lead to both direct and indirect health effects.Most of the deaths directly related to storms are known to occur as a result offlooding (6). Other direct health impacts would include traumatic injuries and posttraumatic stress syndrome.

Indirect health impacts which occur in the aftermath of these events includeoutbreaks of illnesses such as Ross River virus due to breeding of mosquitos inflood water. Breakdown and overflow of sewerage systems can lead to infectiousdiarrhoea and other transmissible diseases as a result of contaminated food andwater. Increased rates of children being admitted to hospital with diarrhoea havebeen observed following El Nino weather events (9).

Infectious Diseases

Research has suggested that the risks of diarrhoeal disease may be augmentedby the increased temperatures which result from climate change.

One study showed that for every degree of increase in temperature the rate ofhospitalisation of children with diarrhoea increased by 8 per cent (9). It has alsobeen predicted that gastrointestinal infections which are already common in ourcommunity such as salmonella, cryptosporidium and campylobacter are likely toincrease with higher temperatures (11,12).

There will be changes in the distribution and intensity of infectious diseaseswhich are spread by insects such as mosquitos. Those of most relevance toAustralia include Dengue fever, an outbreak of which occurred in Townsvillebetween March and August 2007 causing 46 cases (13). During this century, thedistribution of this disease, which until recently has been restricted to areas northof Broome, Katherine and Cairns, has the potential to extend much further southas far as New South Wales depending on how quickly we act to limit greenhouse


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gases (14). Melioidosis is a disease which causes severe pneumonia in thetropical region of the Northern Territory. Its transmission is also dependent onclimate factors and increases with periods of more intense rainfall (15).

Increased Temperatures and Air Pollution

There are many well recognized adverse health effects of air pollution includingcardiac and respiratory disease. What is less well known is that increasedtemperatures may interact with air pollution to compound these illnesses. Groundlevel ozone, which is likely to increase with increasing temperatures, could lead toincreasing prevalence of asthma (16). An American study found that by the2050s, climate change could be responsible for a 4 per cent increase in thedeaths related to ozone, one type of air pollution, in the New York area (12).

Allergy-related Illness

Asthma has been increasing in prevalence in many parts of the world. Otherallergic diseases include eczema and sinusitis. It has been observed that theproduction of pollens, moulds and fungi which give rise to allergic symptoms haveincreased due to temperature changes in some regions. Climate change maytherefore cause people to present for medical care with these conditions inincreasing numbers in the coming decades (9, 12).

Drought and Long-Term Drying

Climate change will result in much of Australia becoming warmer and drier (17).This is predicted to cause increase in drought severity and reduced agriculturalproductivity in southern Australia (1). Drought leads to financial hardship for manyrural Australian families and this could be expected to lead to psychologicaldistress in coming years.

Drought and long-term drying conditions in parts of Australia will also increasethe risks of exposures to extreme environmental conditions (dust, smoke, heat),shortages of water (hygiene consequences), reduced local food supplies (andincreased prices for families with reduced farm incomes), and perhaps changesin health-risk behaviours (smoking, alcohol consumption, self-medication).


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BOX 1. CLIMATE CHANGE: Main categories of risks to health in Australia

• health impacts of extreme weather events (floods, storms, cyclones, bushfires, etc.)

• health impacts of temperature extremes, including heatwaves

• vector-borne infectious diseases (e.g. mosquito-borne dengue fever, Ross River virus)

• food-borne infectious diseases (including from Salmonella, Campylobacter and many other microbes)

• water-borne infectious diseases and risks from poor water quality

• diminished food production: yields, costs/affordability, nutritionalconsequences

• increases in urban air pollution (e.g. ozone), and interaction of thisenvironmental health hazard with meteorological conditions therebyincreasing the risk to health

• increased production of aeroallergens (spores, pollens), thus exacerbating asthma and other allergic diseases

• mental health consequences of social, economic and demographicdislocations (e.g. in parts of rural Australia, and, via disruptions to traditional ways of living, in remote indigenous communities)

• emotional stresses and mental health problems in children, in response to perceptions/fears of climate change and to family stresses (e.g. impaired rural livelihoods)


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Who is Most at Risk in Australia? There are a number of groups within our community who are at particular riskfrom the health impacts of climate change.

Children

The behaviour patterns of children, such as outdoor play are considered to leadto an increased risk of heat stress during heat waves and also increases theirexposure to diseases transmitted by mosquitos (18). Children are often reliant onothers to watch out for their needs (12). Other factors contributing to theirvulnerability include immaturity of their body systems and this would likely lead togreater risk of respiratory conditions associated with enhanced air pollution.Children’s lungs are more susceptible to increased particle density, as occursduring bushfires.

Extreme weather events may cause many children to suffer with post-traumaticstress disorder and following such natural disasters children can suffer with highrates of sleep disturbance, aggressive behaviour, problems with mood and evensubstance abuse. Some studies have suggested that these psychological effectsafter disasters last longer in children than in adults (9).

The Elderly

The elderly in our community are particularly vulnerable to increasedtemperatures (7), particularly those who have cardiovascular and respiratorydiseases (8) This was found during the European heatwaves in 2003 as oldercitizens, particularly those with restricted mobility and chronic medical conditionswere the group most affected (5). Climate modelling studies have shown that intemperate Australian cities, a 75 per cent increase in annual heat-relatedmortality among people 65 years and older may occur by 2050 (8).

Rural, Regional and Remote Communities

Much of rural Australia (especially in the south, south-east and parts of easternAustralia) experienced a severe and prolonged drought during 2001-2007.Economic, social and mental health stresses have resulted. Wellbeing and waysof living continue to be under threat in some regions.

Meanwhile, a longer-term drying process may now be underway. Such a trend,especially in the world’s mid-latitude regions (~ 25-40 deg latitude), is thoughtlikely as the world warms and rainfall systems shift towards the poles. Thecombination of reduced rainfall, increased evaporation, and diminishedstream/river flows mean that soil moisture and crop irrigation will both decline,


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with inevitable impairment of agricultural yields. Further, weather patterns arelikely to become more variable, and include more extreme events.

This situation casts a long shadow over the prospects for rural and regionalAustralia and for many indigenous and remote communities. In summary, adverseimpacts are likely to occur in many domains, including on:

• agricultural productivity;

• exposures to extreme weather events (severe bushfires, floods, dust storms, etc.);

• community functioning and morale;

• mental stress, depression and risk of suicide;

• emotional and developmental effects on children;

• exposures to extremes of heat: impacts on mood, behaviour and workcapacity;

• access to fresh water (irrigation, livestock, domestic and personal hygiene,drinking);

• local food production and availability (affordability) with nutritionalconsequences; and

• other health risks (eg, infectious disease patterns; changes in health-related behaviours).

Climate change will pose a number of complex and unique risks to the healthand well being of rural, regional and remote communities.

Coastal Communities

In the 2 per cent of the world’s coastal areas which are less than 10 metersabove sea level, reside ten percent of the population. Coastal communities in allcountries including Australia are vulnerable to sea coastal surges which will occurfrom a combination of sea level rise and more severe storms (20)


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Australia and the Global Community Having considered the wide range of health impacts which Australians face as aresult of climate change, we must not forget that developing countries will be hithardest by the effects of climate change in terms of water and food security, sealevel rise and extreme weather events. It has been estimated that the reduction infood yields from agriculture in Africa will be as great as 50 per cent by 2020.According to the Intergovernmental Panel on Climate Change, 75–250 millionpeople in Africa will suffer water shortages by this time, and residents of Asia’smegacities will be “at great risk of river and coastal flooding.” (2)

Australia as a global citizen has the opportunity to help address health impactswhich result from climate change in other countries, and the magnitude of thisthreat warrants us considering how Australians might best prepare to help inways including assisting those people who are displaced. Already the citizens ofthe island state of Tuvalu have made plans to emigrate to New Zealand. Whenwe fully take into account the problems facing developing countries, the risk ofwidespread political instability due to limited resources, and potentially millions ofpeople displaced in our region, the need to reduce the degree of climate changeassumes even greater urgency.


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King tide in Kiribati in February 2005. The salt water washes through the cropgardens and contamines fresh water reserves. Photograph © Greenpeace.

Health Care in a Changing Climate Australians will need health care which addresses the health impacts of climatechange. When we consider the wide range of health effects, it becomes evidentthat health care will need to be:

• Responsive to a broad range of emerging threats to health;

• Collaborative with other sectors of the community; and

• Informed by the strategic imperative of reducing greenhouse gas emissionsand limiting the impacts of climate change.

Responsive Health Care 2020

In the coming decades, patients and doctors alike will need to be on the lookoutfor the serious health consequences of climate change such as heat stress.Doctors may be called upon to recognise the early signs of heat related illness.Community and family physicians will be particularly well placed to counsel thoseat higher risk such as the elderly who live alone, about what to do in the event ofextreme temperatures. Such recommendations might include dressing coolly,drinking enough fluids, limiting physical activity during the hottest part of the day,and keeping in the cooler part of the house.

The response of doctors and other health workers will need to be flexible andadaptive in order to meet the wide range and evolving nature of health impacts ofclimate change, whether allergies, respiratory illness, or the traumatic injuriesrelating to storms and floods and bushfires. The adaptive strategies in which thehealth sector can engage in order to minimise health risks associated withclimate change are outlined in Box 2.

Collaborative Health Care 2020

In dealing with the health impacts of climate change doctors and other healthworkers will need to collaborate with communities and organisations in areas suchas disaster preparedness, disease surveillance as well as advocacy for sustainablecommunity design which would include ensuring access to public transport.

Infectious disease transmissionIt is important that sectors of the community collaborate so that outbreaks ofclimate related infectious illnesses are detected at the earliest possible stage.General practitioners may be required to assist with public health strategies formonitoring the spread of diseases which are transmitted by vectors such as insects.


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BOX 2. Some major categories of adaptive strategies to lessen health risksfrom climate change

Activities in which the health sector should lead or participate:

1. Public education, including in health-care settings (doctors’ waiting roomsand hospital clinics)

2. Preventive programs e.g. vaccines, mosquito control, food hygiene and inspection, nutritionalsupplementation

3. Provision of health care (especially mental health promotion and primarycare) for communities affected by environmental adversity (e.g. dryingconditions in rural communities)

4. Surveillance of disease (especially infectious disease) and its keyenvironmental, social and biological risk factors for those diseases

5. Forecasting future health risks from projected climate change

6. Health sector workforce training (primary and in-career) to attune to climate-related health risks

Strategies that extend beyond the formal health sector:

• Community education and mass media campaigns to reduce and preventweather-related health risks

• Early-warning systems for impending weather extremes (e.g. heat-waves,storms)

• Neighbourhood support/watch schemes, to protect those who are mostvulnerable

• Enhanced urban planning: green spaces, shade – reduction of ‘heat island’effect

• Climate-proofed housing design (shade, insulation, ventilation)

• Improved water catchment in water-deprived regions

• Disaster preparedness across sectors (and including the ‘surge’ capacity ofthe health-system)

Based on McMichael et al. (2008) (1)


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Sustainable CommunitiesDoctors and their patients must advocate for sustainable community design andwork with local authorities to ensure that we can all live and work withoutexpending large amounts of energy from fossil fuels. Such measures couldinclude building design which reduces heat accumulation around buildings andwhich allows for good insulation, ventilation and sun-shading.

We must be cautious of adopting interventions which are not sustainable for theenvironment in the long term. Air conditioning may be one way of avoiding heatstress, but if our community heavily relies on such measures which require theburning of fossil fuels, not only would this increase greenhouse gas productionbut also would increase air pollution. Reduction in energy consumption must be akey part of the strategy and part of the solution includes increasing pubicawareness relating to our changing environment.

Communities affected by drought Strategies which have been suggested as ways to assist communities to dealwith prolonged drought include education about the financial and psychologicaleffects of drought, cooperation and coordination between agencies andprofessionals, including doctors, who are involved in delivering health and othercare to these communities, and developing mental health resources which arerobust and skilled in this area (21)

Much of the research about natural disasters relates to supporting victims afteran event has passed, however there are many opportunities to help the sufferersof ongoing problems like drought and more attention needs to be drawn to thisarea (21).

Preventative Health Care for Patients and the Environment

There is much to be gained from doing what we can to reduce greenhouse gasemissions and to attempt to limit the increase of global temperatures. Thebenefits would include preservation of species and protection of endangerednatural environments. These are part of the ecosystems that are our life supportservices and are therefore essential to the health and well being of our owncommunities. It has also been shown that this could improve the health and wellbeing of our own community. A report published by the Australian ConservationFoundation and the Australian Medical Association estimated that implementationof strong policy action on climate change compared to no climate change policycould save between 900 and 1300 lives annually by 2100 (14).

It is therefore particularly important that every citizen and especially every doctor,who frequently has a leadership role in the community, do all they can to findopportunities to decrease greenhouse gas emissions. In the course of patientcare, doctors and other health professionals can recommend and implement


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interventions which are good for health as well as being good for theenvironment (22). Figure 3 shows schematically how the primary health caresector can intervene to promote the reduction in greenhouse emissions as wellas providing health care for those who are affected by health impacts of climatechange.

FIG 3: Adaptive strategies: Intervention opportunities for primary healthcaresystem (11)

Diets with low environmental impactWe are now aware that intensive agriculture, particularly the farming of livestockfor red meat production, requires large amounts of resources and produces largequantities of greenhouse gases. When factors such as deforestation for grazingland and feed production, energy use in growing feed-grains, processing andtransporting grains and meat as well as gases (especially methane) from animalbelching and from manure have been taken into account, the contribution oflivestock production to global greenhouse gas emissions has been estimated tobe in the order of 18% (24). Globally, the consumption of animal products isrising rapidly which is shown in Figure 4.

The way in which livestock is farmed may be difficult to change on a large enoughscale in a short time. There are therefore growing calls in the scientific literature


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Primary health caremitigation strategies

Climate Change

Environmental effects

Extreme weater events• Heatwaves• Fire• Floods• Storms

Eg. Green ClinicProgram (21)

Psychosocial supportNutritional assessment

• Heat stress• Disaster related injuries

• Infectious diseases(eg. Dengue fever andgastroenteritis outbreaks)

• Mental illnesses• Loss of livelihood/

displacement• Poor nutrition

Infectious diseases• Mosquito borne illnesses• Water borne illnesses

Drought and dry conditions• Fresh water scarcity• Reduced food yields

and affordability

Primary health careadaptation strategies

Health effects

Disaster preparedness

Disease surveillanceVaccination

for those in developed countries to reduce red meat consumption and there arepersonal health benefits in so doing. Some groups in the community (e.g. womenwhen they menstruate or are nursing, and elite athletes (24)) that require iron inan easily absorbed state, such as that offered by eating red meat, would still derivehealth benefits from the moderate consumption of lean red meat.

FIGURE 4. Trends in consumption of livestock products per person (includingmilk, eggs, and dairy products, excluding butter) The projected trends assumeno policy- induced change from present consumption. (25)

Physical exercise There are many ways of increasing activity levels which have low environmentalimpact and which produce minimal greenhouse gases. Active transport refers topeople getting from place to place by expending their own metabolic energyrather than sitting in a car. Active transport can involve walking, cycling andcatching public transport.

Physical exercise is good for health in many ways, from reducing obesity topreventing many types of cancer. It reduces rates of heart disease and isassociated with positive changes in mental health. With respect to climate change itis now claimed that those who are fitter will be less susceptible to heat stress (7).


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We must be on the look out for other ways to keep fit and healthy withouttravelling large distances by car. Reduction of motor vehicle use results in cleanerair in our cities and towns, which in turn will lead to better respiratory health andfewer premature deaths especially from heart and lung disease. It has beenestimated that reduction of 50 per cent in greenhouse gas emissions from roadtransport could save between 150 and 250 lives per year from air pollution by2100 (14).

Raising awareness of the health risks of climate change Doctors and health professionals have opportunities to demonstrate ourcommitment to mitigating the causes of climate change to patients. Communityeducation programs have previously resulted in significant improvements inenvironmental impact and it is important that we share any successful strategieswhich engage others in our profession in the quest for sustainability. Somedoctors’ groups have already sought to educate patients using educationalmaterials in waiting rooms and by health promotion (1). The magnitude andurgency of the problem of climate change requires that all who understand thethreats to health and who are in a position of influence must act to shape andstrengthen the community’s attempts to reduce greenhouse gas emissions.

ConclusionClimate change is already a threat to community well-being. It is not only aneconomic issue; it is a threat to our life support systems. In the coming decadesdoctors who are interested in the long term health of their patients andcommunities will have a central role in the mitigation of climate change and inpreparing for and managing its adverse health impacts. The human healthimpacts of climate change for Australia in 2020 will partly depend on how ourcommunity addresses these challenges.


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References1. McMichael AJ, Friel S, Nyong T, Corvalan C. Global environmental change and health: impacts,

inequalities, and the health sector. BMJ 2008; 336:191-4

2. World Health Organisation. Protecting health from climate change – a toolkit for event organisers.http://www.who.int/world-health-day/toolkit/toolkit_en.pdf [Accessed 22/2/08]

3. McMichael AJ, Campbell-Lendrum D, Kovats S, et al. (2004) Climate Change. In: Ezzati M, Lopez AD,Rodgers A, Mathers C (eds.) Comparative Quantification of Health Risks: Global and Regional Burden ofDisease due to Selected Major Risk Factors. Geneva: World Health Organization, 2004, pp.1543-1650.http://www.who.int/publications/cra/chapters/volume2/1543-1650.pdf

4. Tibbetts J. Driven to extremes health effects of climate change. Environmental Health Perspectives2007;115:A196-203

5. Vandentorren S, Bretin P, Zeghnoun A, Mandereau-Bruno L, Croisier A, Cochet C, Ribe´J, Siberan I,Declercq B, Ledrans M. August 2003 Heat Wave in France: Risk Factors for Death of Elderly PeopleLiving at Home European Journal of Public Health 2006; 16: 583–591

6. Sellman J, Hamilton JD. Global climate change and human health. Minnesota Medicine 2007;90:47-50

7. Gosling SN. McGregor GR. Paldy A. Climate change and heat-related mortality in six cities part 1: modelconstruction and validation. International Journal of Biometeorology 2007; 51:525-40.

8. Knowlton K. Lynn B. Goldberg RA. Rosenzweig C. Hogrefe C. Rosenthal JK. Kinney PL. Projecting heat-related mortality impacts under a changing climate in the New York City region. American Journal ofPublic Health 2007; 97:2028-34

9. Shea KM. Global climate change and children’s health. Pediatrics 2007; 120: e1359-1367.

10. Lucas C, Hennessy K, Mills G, Bathols J. Bushfire weather in southeast Australia: recent trends andprojected climate change impacts. Bushfire CRC and Australian Bureau of Meteorology, CSIRO Marineand Atmospheric Research. Consultancy report prepared for the Climate Institute September 2007.[Available at http://www.climateinstitute.org.au/images/stories/bushfire/fullreport.pdf 15 March 2008]

11. Blashki G, McMichael T, Karoly DJ. Climate change and primary health care. Australian Family Physician2007; 36: 986-989.

12 Ebi KL, Paulson JA. Climate change and children. Pediatric Clinics of North America 2007; 54:213-26

13. [Available at www.health.qld.gov.au/dengue/outbreak_update/current.asp[accessed 3 October 2007]

14. Woodruff R, Hales S, Butler C, McMichael AJ. Climate change health impacts in Australia: effects ofdramatic CO2 emission reductions Report for the Australian Conservation Foundation and the AustralianMedical Association, 2005.

15. Currie BJ, Jacups SP. Intensity of rainfall and severity of melioidosis, Australia. Emerging InfectiousDiseases 2003; 9:1538-42

16. Bunyavanich, S., Landrigan, C., McMichael, A., & Epstein, P. (2003). The impact of climate change on childhealth. Ambulatory Pediatrics, 3, 44–52

17. Available at www.csiro.au/resources/ps3bv.html#3 [Accessed 5 September 2007]

18. Arnold RG. Carpenter DO. Kirk D. Koh D. Armour MA. Cebrian M. Cifuentes L. Khwaja M. Meeting report:threats to human health and environmental sustainability in the Pacific basin. Environmental HealthPerspectives 2007; 115:1770-5

19. Sachs JD. Climate change refugees. Scientific American 2007; 296:43

20. IPCC: summary for policymakers. In: Climate change 2007: the physical science basis. Contribution ofWorking Group 1 to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change.Solomon S, Qin D, Manning M, et al, editors. Cambridge: Cambridge University Press.

21. Morrissey SA, Reser JP. Natural disasters, climate change and mental health considerations for ruralAustralia. Australian Journal of Rural Health 2007;15:120-5.

22. Horton G, Magin P. Health patients, healthy planet. Green recommendations for GP health promotion.Australian Family Physician 2007; 36: 1006-1008.

23. American Academy of Pediatrics Committee on Environmental Health. Global climate change andchildrens health. Pediatrics 2007; 120 :1149- 1152

24. McMichael AJ. Powles JW. Butler CD. Uauy R. Food, livestock production, energy, climate change, andhealth. Lancet 2007; 370:1253-63

25. FAO. Livestock’s long shadow. Environmental issues and options. Rome: Food and AgricultureOrganisation, 2006: 15.


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